In medical engineering, it is common in certain diseases of hollow organs, to cut out sick areas of same, for example, sick intestinal areas and to reconnect the two cut ends to each other. Thus, for example, the intestinal end coming from the stomach is sutured at the beginning of the continuing intestinal section.
This is still mainly done by hand, whereby a needle provided with a thread is mounted in a needle holder guided by the physician. For forming the seam, the first lip is hereby held firmly by means of forceps, which is then pierced by the needle in direct vicinity of the forceps. The second lip is then picked up and held firmly with the forceps, which is then likewise pierced in the area of the forceps. This procedure is then repeated so often until the seam is formed along the entire circumference of the intestinal sections, whereby it should be noted that, on the one hand, the two hollow organs are sutured together end to end, and, on the other hand, the inner mucosa does not penetrate outwards.
This type of stitch formation corresponds essentially to the type of formation of a common manual seam of a seamstress or a tailor, whereby the quality of the seam depends primarily on the attention and especially on the skillfulness of the needle guiding by the physician.
A surgical suturing machine, designed as an endoscopic suturing machine, which has a housing that is formed from a housing upper part and a housing shaft adjacent thereto, has become known from DE 101 16 171 A1. The housing upper part here is primarily used for receiving drives for the stitch-forming tools, while the housing shaft is used for receiving means for transmitting the movements generated by the drives to the stitch-forming tools, which means have a thread-carrying needle accommodated by a needle bar and a shuttle cooperating with this needle.
Further, both a needle plate and a holding-down device, which is driven by a drive provided in the housing upper part and is accommodated by a pushing means, is arranged in the area of the lower end of the housing shaft.
For forming a seam, the shuttle is moved, after grasping the thread loop formed by the needle, along a multidimensional path of movement from a position located under the material to be sutured and grasping the thread loop into a position located above the material to be sutured, in which the thread triangle formed by the thread loop guided into the upper side of the material to be sutured encloses the projection of the needle path.
In this way—as shown in FIGS. 8 through 12 of DE 101 16 171 A1—it is possible to form a cover seam using a stitch type corresponding to the stitch type 501.
Thus, this endoscopic suturing machine is suitable for connecting lips, which lie flat on each other or next to each other, to each other by means of a seam of the above-described type and thus for replacing the manual seam formation; however, this endoscopic suturing machine is not provided for forming end-to-end anastomoses on two hollow organs and hence is not optimal.